length of cervix - advice?

(9 posts)(5 voices)
  1. (X-post with the PG/Parenting NY board)

    Hello ladies:

    I'm a serial lurker on these boards (mostly because I'm afraid if I start posting I'm going to jinx my pregnancy), but now I'm in a situation where I really could use advice, so I thought I'd put myself out there.

    I'm currently just over 15 wks with twins. I had a completely uneventful first trimester, thank G-d, but at 13 wks I had to go to the ER with bleeding and clots. According the resident that examined me, my cervix was open. However, the bleeding stopped quickly and luckily my doctor, Dr. Sharma with Cornell MFM, was there that night and examined me. She said my cervix was soft but closed, and sent me home. The next day I had an u/s, which offered no explanation for the bleed, and the babies were doing fine. They measured my cervix, and it was 3.5cm. Dr. Sharma said that was a great number and that nothing needed to be done because anything above a 2.5 is great, but that I should take it very easy and come back in 2 weeks for a cervix check. I asked her about a cerclage, but she said that in twin pregnancies it increases the chances for preterm labor and is generally not a good idea given the risks. At that time she also mentioned possible progesterone shots, but said we would discuss it at the next appointment.

    So I went in again yesterday, after one week of modified bed rest and another week of taking it reeeeally easy, and my cervix now measures 3.1cm. Again, Dr. Sharma is not concerned at all; she says it's fine since it's above 2.5. She thinks the progesterone shots are not warranted. She thinks I should continue to take it easy, but did not say bed rest.

    So of course, I've been googling this stuff non-stop since then and it seems to me that 3.1 is kind of iffy so early in the pregnancy. Not only that, I'm freaking out about the fact that it is shortening. However, Dr. Sharma just doesn't seem to think anything needs to be done about it--she just wants to monitor it every 2 weeks. I'm just afraid that things will change before 2 weeks and that I may enter the danger zone. And it's still so early!

    Has anyone had a similar experience and carried to term without a cerclage? Should I get a second opinion? The Cornell MFM group is well regarded, but it seems to me they don't care about you much until you reach viability.

    Thanks in advance!
    Sara

  2. Sara,

    I did not have the same experience as you appear to be having (my cervix was long and closed the whole time at 5.4 cm), but I thought I would chime in on one thing. At one point I was worried b/c my cervix had gone from 5.4 to 5.0 cm from one 2 week appointment to another. I asked about it and the nurse and my OB told me that it is a fluctuating measurement. For one thing it can depend upon the u/s tech measuring it, and for another it can change over the course of a day. If you have it measured first thing in the morning after you have been laying down it can measure longer than if you have it measured later in the day when you have been on your feet all day (i.e. gravity takes over)!

    Sorry you are having so many worries, but just take it easy and try to keep your spirits up!!! Good luck to you!

    Laura
    mother to Lily and Calvin born Dec 2, 2009

  3. Thanks Laura--that makes me feel better! So I take it your length went back up to 5.4 at your next appointment?
    Congratulations on your twins!

  4. Sara..
    Are you wearing a support belt...ask the doctor if that would take some weight off the cervix?
    SG

  5. Laura is right on, your cervix will funnel to shorten. Funneling can be seen on the U/S. Measurements will very. Take it easy: no stairs, dancing, vaccumming etc. Good luck!

  6. Sara,

    Sorry on the late reply... the babies are keeping me on my toes! But yes, my cervical length measurement went up and down between 5.0 cm and 5.4 cm the entire pregnancy.

    Hope things are still going well for you and good luck!

    Laura

  7. I remember your post from the PG-NY boards... Did you end up seeing another MFM doc? If so, what did s/he say?

  8. Hi ladies--thanks for all of the responses!
    I called Mt. Sinai to see if I could get an appointment for a second opinion, and the receptionist told me I would have to get \"permission\" from Dr. Sharma before they would take me! I didn't feel comfortable doing that - I don't want Dr. Sharma to think I'm totally second-guessing her (at least not at this point) - so I gave up on that for now.

    I did take your other piece of advice though, KALLIOPI, and last Friday called Dr. Sharma and begged to her to let me have another cervix check. She didn't sound too pleased - she probably thinks I'm being too paranoid, but she let me do it, and the measurement came out back up at 3.6 (whew). And I have another check next week, and every two weeks after. So I feel better about the whole thing, but I am still taking it very easy--I spend a loooot of time lying down.

    Suparna, I feel like my belly is big enough yet for a support belt to do any good, but I will definitely keep that in mind as I grow. I do get back pain so it's probably a good idea anyway.

    I wish I could somehow fast-forward through these next 3 months!

  9. Hmmmm, who did you call at Mt Sinai? I am sure that there are other MFMs out there who don't require you to get \"permission,\" first.... Or you can lie, and say that you have been undr your RE's care up until now. Or you can say that your cervix is shortening and you are VERY afraid, and really need to be seen and don't feel good about telling Dr. S about this visit...etc.

    Bummer that Dr. S didn't seem too pleased, she is GETTING PAID to see you, no favors involved here! (sigh) Its your pregnancy and your concerns and you have every right to be your own advocate. Lets, just say I was in L&D many times when I was pg with my twins---I was super worried (had a history of many losses etc), and I didn't care what they thought of me!

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